Interview Series- Amanda Montalvo Women’s Health Dietitian

I recently connected with the wonderful Amanda on instagram and was so impressed by her knowledge and passion for educating and empowering women about their health and hormones.

I wanted to pick her brain about why she decided to focus on womens health, particularly PCOS, her favourite tools for helping to treat PCOS, her thoughts on conventional VS alternative medicine and her top foods she would recommend for balancing hormones, PLUS LOTS MORE.

I loved getting to chat with Amanda, and I just know you will love her too!

For those that don’t know what you do, how would describe it?

I’m a women’s health dietitian, and I help women heal their hormone imbalances, thyroid, and gut
issues naturally using functional lab testing, nutrition, and lifestyle interventions.
The most important aspect of what I do is identifying the root cause of the hormone imbalance.
Hormones are the last thing to change—so much happens in the body before our hormones shift.
When it comes to PCOS, I help women identify what is driving their particular type of PCOS. This
is essential for healing since how PCOS affects each woman is unique. There’s no one size fits all
approach.

What made you choose to focus on women’s health, particularly PCOS?

I got into women’s health because of my own health struggles. Specifically, when I was in college, I was dealing with depression and not feeling like myself. Then during one of my dietetics classes, we were learning about how the pill causes nutrient deficiencies. This blew my mind since I had been taking the pill for seven years, and no doctor had ever shared this with me. I started doing a ton of research and that some women don’t respond well to the synthetic hormones in the pill and decided to get off. After I stopped the pill, all of my acne came back (and got worse), my period disappeared, and I had extreme fatigue. I eventually learned that I had post-pill PCOS and a low functioning thyroid. This drove me to do even more research on PCOS and thyroid health, and the lack of education around our cycles and birth control was disappointing, and I wanted to change that.

It took me 3 doctors to get the post-pill PCOS diagnosis, and I was in the medical field. I couldn’t even imagine what women that weren’t as familiar were going through. Bottomline, women deserve better healthcare, and I knew I needed to raise awareness around this.

What tools do you use to diagnose PCOS?

I don’t diagnose PCOS since I’m not a doctor, but to find out if a woman has PCOS and what is driving it, I use a DUTCH test to look at sex and stress hormones. This is the most comprehensive hormone test out there. You can’t just look at hormone levels; you need to see their metabolites and understand what pathways they are going down in the body. This plays a huge role in healing protocols for PCOS.

The other areas I look at are mineral balance and gut health. Mineral balance is one of the most under-examined areas when it comes to hormone health, in my opinion. It’s so easy to have a deficiency and have that impact hormone production, thyroid health, and blood sugar balance.

Gut health is essential because no matter what type of PCOS you have, it’s crucial to identify all stressors on the body. Some of the most common stressors I see are in the gut. These are things like poor digestion and absorption of food, which makes it difficult to get the nutrients we need. When you have parasites, pathogenic bacteria or yeast, it’s also stressful on the body. Our bodies can’t tell the difference between being stuck in traffic, running from a bear, or a parasite. It’s all stress and causes the same stress response that causes a release of cortisol (our stress hormone) that can exacerbate PCOS symptoms by causing more insulin resistance.

These tests also allow us to see what’s driving each woman’s specific symptoms. PCOS is nuanced. Some women’s symptoms are driven by stress and the adrenals, some are driven purely by insulin resistance, and some are more related to inflammation. Most commonly, I see a combination of all three.

Using these tests allows me to get super specific when it comes to supplements, nutrition, and lifestyle changes, and will enable women to feel better faster and be confident that their protocol is meeting their unique needs.

Do you find that it is often misdiagnosed?

Yes! I often see women that are told they have hypothalamic amenorrhea and it’s really PCOS or vice versa. I also see hypothyroidism being diagnosed as PCOS. I’ve also had clients that are told they have PCOS, but don’t meet the criteria. I think there’s a lot of confusion around what qualifies and every doctor has their own take on the condition.

What methods of treatment have you found best for managing clients with PCOS?

This depends on the woman, but generally, focusing on support gut health digestion, balancing minerals, and reducing insulin resistance are what helps move the needle and reduce symptoms.

One of my favorite supplements for insulin resistance and improving ovarian function to support ovulation and regular cycles is a combination of inositol and d-chiro inositol. It’s so important to have a 40:1 ratio for this though. There is a growing body of research that shows this is

What advice would you give to a women who has been newly diagnosed with PCOS?

Find a qualified practitioner that can help you pinpoint what is driving your specific type of PCOS. I see so many women attempt restrictive diets, under-eat, and spend a lot of money on supplements. Remember that your PCOS is different from every other woman with it. So a nutrition approach that works for one woman may not work for you. It’s essential to find someone you trust to work with and then keep your eyes on your own paper. There’s a lot of information out there on PCOS, some of it is good, and some of it is harmful. Understanding your type helps you sift through the BS and know what’s right for YOU.

Conventional medicine typically prescribes the pill for PCOS, and I’m not okay with that. It’s a bandaid that shuts down hormone production and can lead to more nutrient deficiencies, inflammation, and insulin resistance. The other conventional medication prescribed is Metformin, which has a laundry list of side effects, many of which negatively impact digestion and result in a lower quality of life. Metformin also depletes vitamin B12.

When it comes to PCOS, there are natural supplements like inositol, green tea extra, and herbal androgen blockers that work. This isn’t just my opinion either, there is a lot of research out there that supports this, and it’s only growing. I think conventional medicine is behind when it comes to the research since we have several alternative therapies that we know work.

We also know that nutrition and lifestyle are huge for managing symptoms. PCOS may be a lifelong condition, but it’s not a death sentence. There’s a lot within our control that allows us to heal and manage symptoms long-term.

What are the best and worst foods for PCOS?

I don’t think any foods are necessarily bad for PCOS. The most important thing to remember is balancing your meals and snacks. Pairing carbs with protein, fiber, and healthy fats allows our bodies to break them down slowly and won’t spike your blood sugar as much. Eating carbs alone can spike your blood sugar and lead to more insulin resistance and eventually, more PCOS symptoms.

One of the most critical parts of long-term healing with PCOS is finding a sustainable approach. PCOS doesn’t just go away, so you need a lifestyle that you can maintain for the long haul. Extreme food restriction doesn’t work and isn’t necessary for longterm health.

Where can we find you?

I’m the most active on Instagram and have SO many posts on PCOS. You can follow me here: